Healthcare is increasingly framed as a market commodity, yet its costs and consequences are borne across society. In Oregon, families, seniors, employers, and public programs collectively spend tens of billions of dollars each year on a system characterized by administrative complexity, fragmented coverage, and significant financial barriers to care.

This framework explores the concept of universal healthcare access—one in which essential medical, dental, vision, mental health, and long-term care services are available without point-of-service financial barriers. By examining alternatives to premium-driven and fee-heavy insurance models, the goal is to consider whether broader access could reduce delayed care, medical debt, and systemic inefficiencies while improving population health outcomes.

Analyses of universal-access healthcare models frequently suggest that total system costs may be comparable to—or lower than—current aggregate healthcare spending when administrative inefficiencies and fragmented payment structures are reduced. In Oregon’s case, this framework examined estimates in the range of approximately $57 billion annually, roughly aligning with existing public and private healthcare expenditures.

Rather than increasing overall household burden, the model explored restructuring existing funding streams to improve equity and sustainability. Potential funding mechanisms considered included the realignment of federal healthcare dollars already flowing through Medicare, Medicaid, and ACA programs; modest, progressive state-level contributions based on income thresholds; employer payroll participation designed to replace higher private insurance costs; and administrative savings achieved through system consolidation. Taken together, these elements were examined as part of a broader inquiry into whether universal access could be financed through reallocation and efficiency rather than net cost expansion.